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Diagnostic mammography

Diagnostic mammography: problem solving, additional views: ML: Medio-Lateral 90 degrees (triangulate lesion, milk of calcium eval) Spot compression: views with magnification (air gap, 1.5 - 2 x magnification, 0.1mm focal spot), SIO: Supero-Inferior Oblique AT: Axillary Tail (AT) Cleavage view (AT): Kleopatra view, valley view - eval of the far medial and posterior breast TAN Tangential view: for skin calcs RL, RM - Roll lateral, medial: separate superimposed tissues - if the real abnormality is in the upper half of the breast it will move medially on RM, lateral if it is in the bottom half and opposite for RL view FB: Caudocranial (FB) From Below Compression: improves image by reducing breast thickness, which reduces scatter, dose and patient motion; 25-45 pounds Posterior Nipple Line - PNL: axis of the nipple, line from the nipple equally bisecting the breast extending to pectoral muscle Inframammary skin fold: should be seen w/ well positioned breast The pectoralis must extend to or below the PNL. Triangulation: Put CC, MLO and ML in row with nipples in line. Mass should be connected by line. If not it is not the same mass. Line rotates around the center on MLO ⇒ if it goes down on CC (towards inner, medial aspect) it must go up on ML and vice versa.